JP3526487B2 - 医療用縫合材 - Google Patents
医療用縫合材Info
- Publication number
- JP3526487B2 JP3526487B2 JP10983395A JP10983395A JP3526487B2 JP 3526487 B2 JP3526487 B2 JP 3526487B2 JP 10983395 A JP10983395 A JP 10983395A JP 10983395 A JP10983395 A JP 10983395A JP 3526487 B2 JP3526487 B2 JP 3526487B2
- Authority
- JP
- Japan
- Prior art keywords
- suture material
- shape
- main
- medical
- suture
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07292—Reinforcements for staple line, e.g. pledgets
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00004—(bio)absorbable, (bio)resorbable, resorptive
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0815—Implantable devices for insertion in between organs or other soft tissues
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Materials For Medical Uses (AREA)
- Surgical Instruments (AREA)
Description
に縫い合わされる医療用縫合材に関するものであり、特
に自動縫合器に装着して使用される医療用縫合材に関す
るものである。
手術によるのが一般的であるが、患者に対する負担の軽
減などを目的に、内視鏡下での手術等が施術されるよう
になってきている。
その一例である。自動縫合器は、穿孔から生体内へ導入
され、患部を切除すると同時に切除部位の縫合を行うも
のであり、これを用いることで患部の切開が不要となる
という利点がある。したがって、上記自動縫合器は、先
端に生体組織の切除部位を挟み込む縫合機構部を有し、
さらにこの縫合機構部には、縫合のための複数のステー
プルラインや生体組織の切断機構(例えばナイフ)が設
けられている。
合器の使用は、縫合、切開時間の短縮や、施術の簡便化
に有利である。
脆弱な組織に対して前述の自動縫合器で施術する場合、
ステープルによる縫合のみでは、組織の断裂の虞があ
り、また、例えば肺の手術においては、空気漏れが発生
する虞がある。前記空気漏れは、患者にとって致命的で
あり、これを確実に防止することが望まれる。
着しておき、これを生体組織の切除部位にステープルで
縫い合わせるということが行われている。
とし、確実に患部に到達させるためには、何らかの工夫
が必要であり、例えば、フェルト状の縫合材に伸縮性ニ
ットを重ね、これらを仮縫い糸で両側縁に沿って縫い付
け、筒状にしたものが提案されている。
ニットを縫い付けて自動縫合器への装着を可能とした縫
合材では、自動縫合器を生体内に挿入して患部へ導入す
る際に、挿入方向で収縮し自動縫合器の基端側に片寄っ
たり、自動縫合器の周囲で回転(いわゆるツイスト)す
る等の不都合が発生している。
処置が難しく、特に内視鏡下のような限られた視野での
施術の際に、大きな問題となる。
提案されたものであって、自動縫合器の挿入時に片寄り
や回転が発生することがなく、例えば肺の手術に用いた
場合に空気漏れを確実に防止することが可能な医療用縫
合材を提供することを目的とする。
めに、本発明の医療用縫合材は、不織布、織布、ニット
から選ばれる少なくとも1種よりなる主縫合材と、主縫
合材より剛性の高いフィルム又はシートよりなる形態維
持性支持材とからなり、主縫合材と形態維持性支持部材
とは、互いに重ね合わせられるとともに、上記重ね合わ
せられた各部材の両側縁から先端側が単一の縫糸により
縫い合わせられることによって、ステープルラインを有
する自動縫合器に装着可能なように、基端部側を開放
し、上記先端側を閉塞した袋状に縫合したものである。
フェルトのような不織布や、織布、ニット等、ある程度
の柔軟性、伸縮性を有するものであれば任意の形態のも
のが使用でき、その材質も公知のものがいずれも使用で
きるが、術後を考えると、ポリグリコール酸のような生
体吸収性高分子や生体組織の一部、例えば心のう膜等の
臓器保護膜を用いることが望ましい。
加わっても変形することのない剛性を有する材料が用い
られ、例えばプラスチックや金属、紙等のシート状ある
いはフィルム状の材料が用いられる。
ることがなく、したがってこれを縫い合わせ筒状にした
縫合材は、自動縫合器挿入の際に挿入方向に収縮するこ
とによる片寄りが発生することはない。
いて、図面を参照しながら詳細に説明する。
ように、吸収性ポリグリコール酸のフェルト(例えば、
グンゼ社製、商品名ネオベール等)よりなる主縫合材2
と、プラスチックシートよりなる形態維持性支持材3と
を縫い合わせてなるものである。
ル酸のような生体吸収性高分子の他、従来縫合材として
用いられているものが使用可能である。例えば、心のう
膜等の臓器保護膜のような生体組織の一部を使用するこ
とも可能である。
チックシートに限らず、金属シート、紙など、ある程度
剛性を有する材料であれば、いずれも使用可能である。
は、後述の自動縫合器の装着部位の長さとほぼ等しい長
さを有する短冊状とされ、幅方向両側縁に沿って2本の
縫糸4、5によって縫い合わされている。
ると、いわゆるモノフィラメントがよく、その材質は任
意である。例えば、生体吸収性ポリマーの糸や、滑り性
の良好なポリアミド糸(いわゆるナイロン糸)等が好適
である。
態としておき、縫合終了後に主縫合材2や形態維持性支
持材3から個々に抜き取るようにしてもよいし、あるい
は形態維持性支持材3側で末端に結び目等の抜け止めを
設け、縫合終了後に形態維持性支持材3を抜き取ると同
時にこれら縫糸4、5が抜き取られるような構成として
もよい。
幅をW1、形態維持性支持材3の幅をW2としたときに、
W1<W2とされている。すなわち、形態維持性支持材3
の方が主縫合材2よりも幅広とされている。
材2を配し、背面側を形態維持性支持材3で覆って装着
状態を安定なものとするためで、このような設定とする
ことで、自動縫合器装着時の回転が防止される。
ートよりなる形態維持性支持材3に対して折り曲げ加工
を施し、自動縫合器の装着部位の外形形状に合わせた形
状にしておけば、装着状態が極めて安定なものとなり、
前記回転を確実に防止することができる。
幅を形態維持性支持材3の幅よりも大として、形態維持
性支持材3をある程度覆うような構成とすることも可能
である。
縫合器に装着して使用される。そこで次に、自動縫合器
の構造、並びに本実施例の医療用縫合材の使用方法につ
いて説明する。
ト11の先端に開閉自在な縫合部12を有してなるもの
であって、基端部には把持・操作するための操作部13
が設けられている。
テープルが収容されたカートリッジやナイフブレードが
装填される縫合機構部12a及び生体組織を挟み込むた
めの顎部12bとからなり、縫合機構部12aの挟み込
み面には、複数(本例では、3列×3列=6列)のステ
ープルライン14やナイフの走査ライン15が臨んでい
る。
るアタッチメントを介して生体内に導入される。すなわ
ち、先ず、生体に設けた穿孔にサージポートを装着し、
このサージポートを通して自動縫合器のシャフト11を
生体内へと挿入する。これによって、生体に設けた穿孔
の密閉が保たれる。
縫合部12に装着して使用される。図5は、縫合材1を
自動縫合器の縫合部12に装着した状態を示すもので、
縫合機構部12a及び顎部12bにそれぞれ縫合材1が
取り付けられる。
チックシートよりなる形態維持性支持材3に沿って縫合
部12を滑らすことで円滑に行うことができ、特に形態
維持性支持材3を縫合部12の形状に合わせて矩形に折
り曲げ加工した場合には、背面側の平坦面を利用して、
容易に装着することができる。
トを介して自動縫合器を生体内へと挿入し、患部へと到
達させる。このとき、自動縫合器に装着される縫合材1
は、形態維持性支持材3によって補強されたかたちにな
っているので、収縮による片寄りやツイストが発生する
ことはない。
すように、生体組織20の切除部位を縫合機構部12a
及び顎部12bによって挟み込む。これによって、前記
切除部位は主縫合材2で覆われることになる。
た操作レバー13aを操作し、前記ステープルライン1
3からステープルを打針する。
沿ってステープルが打針され、縫合処置が施されるが、
このとき、同時に縫合部12に装着された縫合材1の主
縫合材2が生体組織20の切除部位に押し当てられ、前
記ステープルによって縫合される。
て機能し、生体組織20の切断部分をこの主縫合材2を
介して縫合することで、組織の断裂が防止され、例えば
巨大肺のう胞の切除術等においては、空気漏れが防止さ
れる。
イフを走査ライン15に沿って走査し、生体組織20及
び主縫合材2を切断する。
り、余分な部材、すなわち形態維持性支持材3を生体内
から除去する。この形態維持性支持材3を除去するに
は、主縫合材2と形態維持性支持材3とを縫い合わせて
いる縫糸4、5を引き抜いてこれらを分離した後、前記
形態維持性支持材3を生体内から取り出せばよい。ある
いは、前述のように形態維持性支持材3側の末端に結び
目等の抜け止めを設けた場合には、縫合終了後に形態維
持性支持材3を抜き取ると同時に縫糸4、5を抜き取る
ことも可能である。
の縫合材1を用いることによって、縫合操作を円滑に進
めることができ、しかも確実に縫合部位の補強、空気漏
れの防止を行うことができる。図7は、縫合終了状態を
示すものであり、生体組織20の縫合部位には、主縫合
材2が縫い合わされ、縫合状態が極めて安定なものとな
っている。
が、本発明は、具体的に、次のように構成される。すな
わち、上述の例では、主縫合材1と形態維持性支持材3
とを縫い合わせた縫合材1の両端部を開放した状態とし
たが、本発明は、図8に示すように、主縫合材2あるい
は形態維持性支持材3の端部を折り返し、1本の縫糸4
によって先端が閉塞された袋状に縫い合わせる。このよ
うに先端を閉塞した場合には、自動縫合器に装着して生
体内に挿入する際に、縫合材1を自動縫合器で押し込む
ことになり、縫合材1の片寄り防止は一層確実なものと
なる。
明の縫合材においては、柔軟性を有する主縫合材をある
程度剛性のある支持材によって支持するようにしている
ので、自動縫合器挿入時に発生する縮みによる片寄りや
ツイスト等を防止することができる。
によって、縫合部位の補強を確実に行うことができ、組
織の断裂や空気漏れを抑えることが可能である。
図である。
視図である。
る。
視図である。
図である。
例を示す概略斜視図である。
支持材、 4 縫糸、 13ステープルライン
Claims (8)
- 【請求項1】不織布、織布、ニットから選ばれる少なく
とも1種よりなる主縫合材と、上記主縫合材より剛性の高い フィルム又はシートよりな
る形態維持性支持材とからなり、 上記主縫合材と上記形態維持性支持部材とは、互いに重
ね合わせられるとともに、上記重ね合わせられた各部材
の両側縁から先端側が単一の縫糸により縫い合わせられ
ることによって、ステープルラインを有する自動縫合器
に装着可能なように、基端部側を開放し、上記先端側を
閉塞した袋状に縫合 されていることを特徴とする医療用
縫合材。 - 【請求項2】上記主縫合材が合成高分子よりなることを
特徴とする請求項1記載の医療用縫合材。 - 【請求項3】上記合成高分子が生体吸収性高分子である
ことを特徴とする請求項2記載の医療用縫合材。 - 【請求項4】上記生体吸収性高分子がポリグリコール酸
であることを特徴とする請求項3記載の医療用縫合材。 - 【請求項5】上記主縫合材が生体組織の一部よりなるこ
とを特徴とする請求項1記載の医療用縫合材。 - 【請求項6】上記生体組織が臓器保護膜であることを特
徴とする請求項5記載の医療用縫合材。 - 【請求項7】上記生体組織が心のう膜であることを特徴
とする請求項6記載の医療用縫合材。 - 【請求項8】上記形態維持性支持材がプラスチック、金
属、紙から選ばれる少なくとも1種よりなることを特徴
とする請求項1記載の医療用縫合材。
Priority Applications (9)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP10983395A JP3526487B2 (ja) | 1995-05-08 | 1995-05-08 | 医療用縫合材 |
DE69629263T DE69629263T2 (de) | 1995-05-08 | 1996-05-08 | Medizinisches nähmaterial |
AT96913704T ATE245944T1 (de) | 1995-05-08 | 1996-05-08 | Medizinisches nähmaterial |
CA002194170A CA2194170C (en) | 1995-05-08 | 1996-05-08 | Medical suturing material |
US08/765,942 US5766188A (en) | 1995-05-08 | 1996-05-08 | Medical suturing material |
EP96913704A EP0770356B1 (en) | 1995-05-08 | 1996-05-08 | Medical suture material |
AU56589/96A AU709545B2 (en) | 1995-05-08 | 1996-05-08 | Medical suturing material |
KR1019960707423A KR100289262B1 (ko) | 1995-05-08 | 1996-05-08 | 의료용봉합재 |
PCT/JP1996/001220 WO1996035377A1 (fr) | 1995-05-08 | 1996-05-08 | Materiau de suture medicale |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP10983395A JP3526487B2 (ja) | 1995-05-08 | 1995-05-08 | 医療用縫合材 |
Publications (2)
Publication Number | Publication Date |
---|---|
JPH08299427A JPH08299427A (ja) | 1996-11-19 |
JP3526487B2 true JP3526487B2 (ja) | 2004-05-17 |
Family
ID=14520366
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP10983395A Expired - Lifetime JP3526487B2 (ja) | 1995-05-08 | 1995-05-08 | 医療用縫合材 |
Country Status (8)
Country | Link |
---|---|
US (1) | US5766188A (ja) |
EP (1) | EP0770356B1 (ja) |
JP (1) | JP3526487B2 (ja) |
AT (1) | ATE245944T1 (ja) |
AU (1) | AU709545B2 (ja) |
CA (1) | CA2194170C (ja) |
DE (1) | DE69629263T2 (ja) |
WO (1) | WO1996035377A1 (ja) |
Families Citing this family (643)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5810855A (en) * | 1995-07-21 | 1998-09-22 | Gore Enterprise Holdings, Inc. | Endoscopic device and method for reinforcing surgical staples |
US6001051A (en) * | 1998-06-15 | 1999-12-14 | Chuan-Pin; Chang | Body exerciser |
DE19924311A1 (de) * | 1999-05-27 | 2000-11-30 | Walter A Rau | Klammerschneidegerät und Zusatzvorrichtung für ein solches |
US6325810B1 (en) | 1999-06-30 | 2001-12-04 | Ethicon, Inc. | Foam buttress for stapling apparatus |
US6273897B1 (en) | 2000-02-29 | 2001-08-14 | Ethicon, Inc. | Surgical bettress and surgical stapling apparatus |
US6592597B2 (en) * | 2001-05-07 | 2003-07-15 | Ethicon Endo-Surgery, Inc. | Adhesive for attaching buttress material to a surgical fastening device |
EP1494594B1 (en) * | 2002-04-15 | 2011-07-06 | Cook Biotech Incorporated | Apparatus and method for producing a reinforced surgical staple line |
US6736854B2 (en) * | 2002-05-10 | 2004-05-18 | C. R. Bard, Inc. | Prosthetic repair fabric with erosion resistant edge |
JP4551214B2 (ja) | 2002-06-17 | 2010-09-22 | タイコ ヘルスケア グループ エルピー | 環状支持構造体 |
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JP2604025Y2 (ja) * | 1993-11-29 | 2000-04-10 | グンゼ株式会社 | 自動縫合器用縫合補綴材 |
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IT1290375B1 (it) * | 1994-06-03 | 1998-12-03 | Gunze Kk | Elemento in materiale biodegradabile e bioassorbibile utilizzabile in campo chirurgico per il rinforzo delle zone di tessuto da cucire. |
JP3136392B2 (ja) * | 1994-06-03 | 2001-02-19 | グンゼ株式会社 | 縫合補綴材 |
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1995
- 1995-05-08 JP JP10983395A patent/JP3526487B2/ja not_active Expired - Lifetime
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1996
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- 1996-05-08 US US08/765,942 patent/US5766188A/en not_active Expired - Lifetime
- 1996-05-08 EP EP96913704A patent/EP0770356B1/en not_active Expired - Lifetime
- 1996-05-08 DE DE69629263T patent/DE69629263T2/de not_active Expired - Lifetime
- 1996-05-08 CA CA002194170A patent/CA2194170C/en not_active Expired - Fee Related
- 1996-05-08 WO PCT/JP1996/001220 patent/WO1996035377A1/ja active IP Right Grant
- 1996-05-08 AU AU56589/96A patent/AU709545B2/en not_active Ceased
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EP0770356A1 (en) | 1997-05-02 |
EP0770356A4 (en) | 1998-02-11 |
ATE245944T1 (de) | 2003-08-15 |
DE69629263T2 (de) | 2004-05-27 |
AU709545B2 (en) | 1999-09-02 |
US5766188A (en) | 1998-06-16 |
WO1996035377A1 (fr) | 1996-11-14 |
EP0770356B1 (en) | 2003-07-30 |
AU5658996A (en) | 1996-11-29 |
CA2194170C (en) | 2007-03-27 |
DE69629263D1 (de) | 2003-09-04 |
JPH08299427A (ja) | 1996-11-19 |
CA2194170A1 (en) | 1996-11-14 |
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